Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 159316 | NY |
NPI | 1023034428 |
---|---|
Provider Name | Lawrence Jindra |
First Address | Floral Park, NY 11001-3215 |
Second Address | Floral Park, NY 11001-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 30/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01978207 | (05) | NY |
A64411 | (02) | NY |